P Patenotre

Centre Hospitalier Régional Universitaire de Lille, Lille, Nord-Pas-de-Calais, France

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Publications (56)38.66 Total impact

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    Annales de Chirurgie Plastique Esthétique 03/2015; DOI:10.1016/j.anplas.2015.02.004 · 0.59 Impact Factor
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    ABSTRACT: Iconographie disponible sur CD et Internet.
    Annales de Dermatologie et de Vénéréologie 12/2014; 141(12):S463. DOI:10.1016/j.annder.2014.09.524 · 0.67 Impact Factor
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    ABSTRACT: The inferior gluteal musculocutaneous flap described by Shaw then Le-Quang offers the possibility of harvesting a large amount of tissue with a well-concealed scar in the inferior fold. Since 1996, we used this flap for breast reconstruction without implant. The purpose of this study was to assess short and for long-term results in our patients. Between 1996 and 2005, 64 patients underwent 69 musculocutaneous flaps by two seniors surgeons, for secondary unilateral reconstruction (57 cases, 51 total mastectomy, three partial mastectomy, three constitutional breast asymmetry), five bilateral reconstruction or one thoracic skin ulceration after radiotherapy. The average flap weight and size was respectively 360g and 18 × 7cm. For short results, the assessment was based on flap success and surgical morbidity. For long-term results, the assessment was based on breast result (shape, volume, symmetry, skin and scar) and donor-site morbidity (scar, contour deformity, muscle function and sensation). Patients and surgeons global satisfaction were compared. Minimal follow-up was three years for 60 patients. Two patients died with metastasis. Sixty-three flaps succeeded. We had five flap necrosis, one after general complication (pulmonary embolism), four after venous thrombosis during the first period of our experience. Forty patients underwent a second procedure on the flap or on the other breast (25 cases). For the patients, the global result was excellent in 20 cases, good in 32 cases, fair in nine cases. For surgeons the global result was excellent in 13 cases, good in 32 cases, fair in 13 cases and poor in three cases. Concerning the donor-site, only one patient had an asymmetry of the buttock. Mostly, the scar of the donor site was good. Five cases needed a new surgery for poor scar. Five patients had functional complaints (for bicycle and squatting). Twenty-three patients noticed the hypoesthesia in the territory of the posterior femoral cutaneous nerve. For breast reconstruction, the gluteal region is an acceptable donor site with low morbidity and stable results. This technique needed a relative long learning curve, especially for the venous pedicle. We recommend to use a large vein dissected from the arm and axillary vessels. We also reduce the harvesting volume of the muscle to preserve the function. The reconstructive breast had a good shape, sufficient volume and acceptable symmetry.
    Annales de chirurgie plastique et esthetique 12/2010; 55(6):512-23. · 0.59 Impact Factor
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    ABSTRACT: The inferior gluteal musculocutaneous flap described by Shaw then Le-Quang offers the possibility of harvesting a large amount of tissue with a well-concealed scar in the inferior fold. Since 1996, we used this flap for breast reconstruction without implant. The purpose of this study was to assess short and for long-term results in our patients. Between 1996 and 2005, 64 patients underwent 69 musculocutaneous flaps by two seniors surgeons, for secondary unilateral reconstruction (57 cases, 51 total mastectomy, three partial mastectomy, three constitutional breast asymmetry), five bilateral reconstruction or one thoracic skin ulceration after radiotherapy. The average flap weight and size was respectively 360 g and 18 × 7 cm. For short results, the assessment was based on flap success and surgical morbidity. For long-term results, the assessment was based on breast result (shape, volume, symmetry, skin and scar) and donor-site morbidity (scar, contour deformity, muscle function and sensation). Patients and surgeons global satisfaction were compared. Minimal follow-up was three years for 60 patients. Two patients died with metastasis. Sixty-three flaps succeeded. We had five flap necrosis, one after general complication (pulmonary embolism), four after venous thrombosis during the first period of our experience. Forty patients underwent a second procedure on the flap or on the other breast (25 cases). For the patients, the global result was excellent in 20 cases, good in 32 cases, fair in nine cases. For surgeons the global result was excellent in 13 cases, good in 32 cases, fair in 13 cases and poor in three cases. Concerning the donor-site, only one patient had an asymmetry of the buttock. Mostly, the scar of the donor site was good. Five cases needed a new surgery for poor scar. Five patients had functional complaints (for bicycle and squatting). Twenty-three patients noticed the hypoesthesia in the territory of the posterior femoral cutaneous nerve. For breast reconstruction, the gluteal region is an acceptable donor site with low morbidity and stable results. This technique needed a relative long learning curve, especially for the venous pedicle. We recommend to use a large vein dissected from the arm and axillary vessels. We also reduce the harvesting volume of the muscle to preserve the function. The reconstructive breast had a good shape, sufficient volume and acceptable symmetry.
    Annales de Chirurgie Plastique Esthétique 12/2010; 55(6):512-523. DOI:10.1016/j.anplas.2009.12.006 · 0.59 Impact Factor
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    ABSTRACT: To the best of our knowledge, only 52 cases of squamous cell carcinoma (SCC) complicating hidradenitis suppurativa (HS) have been reported since 1958. We describe 13 new cases. We propose a clinical and histological analysis of our cases. We include these results in a review of previously reported cases to analyze a total of 65 patients. In our series of 13 cases, we also investigate the presence of human papillomavirus (HPV) in tumor samples, by polymerase chain reaction (PCR) on paraffin-embedded material. Malignant transformation affects mainly men with a long-term history of genitoanal HS. Although our cases were 7 well-differentiated carcinomas and 6 verrucous carcinomas, lymphatic and visceral metastasis occurred in 2 and 3 cases, respectively. With PCR, we demonstrated presence of HPV in genitoanal tumoral lesions, principally HPV-16. SCC complicating HS evolves poorly, despite a good histological prognosis. Our results sustain the implication of HPV in the malignant transformation of HS.
    Dermatology 12/2009; 220(2):147-53. DOI:10.1159/000269836 · 1.69 Impact Factor
  • V. Duquennoy-Martinot · P. Patenôtre
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    ABSTRACT: L’evoluzione attuale della ricostruzione mammaria è legata all’utilizzo di tessuti autologhi, senza materiale protesico. Il lembo gluteo inferiore libero può essere realizzato nei pazienti di tutte le età nella ricostruzione differita e anche in quella immediata, uni- o bilaterale. L’indicazione può essere rappresentata dagli esiti di una mastectomia totale, di una mastectomia parziale o anche di una mastectomia sottocutanea con conservazione del tessuto cutaneo. Si può ricorrere a questo lembo anche per conversione nei casi di una ricostruzione con materiale protesico che ha dato un risultato insoddisfacente. Il lembo muscolocutaneo vascolarizzato dall’arteria glutea inferiore, è generalmente anastomizzato in terminoterminale sull’arteria toracodorsale o sull’arteria circonflessa scapolare e, spesso, su una vena omerale ruotata per evitare le incongruenze di calibro. La sorveglianza postoperatoria deve essere ben svolta. Possono essere necessari dei gesti complementari: simmetrizzazione, ritocco sul lembo, ricostruzione del complesso areola-capezzolo. Gli inconvenienti di tale metodica sono: i rischi di insuccesso della microchirurgia, la lunghezza dei tempi operatori (in media cinque ore), la qualità incostante della cute glutea e l’ipoestesia della faccia posteriore della coscia. Al contrario, i vantaggi controbilanciano largamente tali inconvenienti: un volume costantemente sufficiente (da 300 a 500 g), la semplicità del prelievo dopo una curva d’apprendimento obbligatoria e, soprattutto, la scarsità degli esiti cicatriziali e dei disturbi funzionali provocati, molto ridotti. Tale lembo occupa dunque un posto di scelta nell’arsenale terapeutico del chirurgo plastico, accanto ai lembi addominali (lembo addominale peduncolato sul muscolo retto dell’addome [TRAM], deep inferior epigastric perforator [DIEP]) e lembo di gran dorsale allargato.
    12/2007; 5(4):1–9. DOI:10.1016/S1769-6704(07)70101-8
  • V. Duquennoy-Martinot · P. Patenôtre
    01/2007; 2(2):1-8. DOI:10.1016/S1286-9325(07)46619-5
  • V. Duquennoy-Martinot · P. Patenôtre
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    ABSTRACT: La evolución actual de la reconstrucción mamaria consiste en la utilización de tejidos autólogos, sin materiales protésicos. El colgajo glúteo inferior libre puede realizase en pacientes de cualquier edad, en reconstrucción tanto diferida como inmediata y uni o bilateral. La indicación puede establecerse tras una mastectomía total, parcial o incluso en una mastectomía subcutánea con conservación del recubrimiento cutáneo. También puede tratarse de una conversión de una reconstrucción mediante material protésico que haya dado un resultado insatisfactorio. El colgajo musculocutáneo, vascularizado por la arteria glútea inferior, suele anastomosarse de forma terminoterminal en la arteria toracodorsal o incluso en la circunfleja de la escápula y, con más frecuencia, en una vena humeral desviada para evitar las incongruencias de calibre. La vigilancia postoperatoria debe ser exhaustiva. Puede que se requieran intervenciones complementarias: simetrización, retoques del colgajo o reconstrucción de la placa areolomamilar. Los inconvenientes de este método son los riesgos de fracaso de la microcirugía, la duración de la intervención (un promedio de 5 horas), la calidad inconstante de la piel glútea y la hipoestesia de la cara posterior del muslo. En cambio, las ventajas contrarrestan ampliamente estos inconvenientes: aportación constante de un volumen suficiente (300-500 g), simplicidad de la extracción tras la obligatoria curva de aprendizaje y, sobre todo, escasa retracción cicatrizal y provocación de pocos trastornos funcionales, que son muy limitados. Por tanto, este colgajo supone una alternativa de elección en el arsenal terapéutico del cirujano plástico, junto a los colgajos abdominales (colgajo abdominal pediculado sobre el músculo recto del abdomen [TRAM], perforante epigástrica inferior profunda [DIEP]) y colgajo de dorsal ancho ampliado.
    01/2007; 15(4):1–9. DOI:10.1016/S1634-2143(07)70398-9
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    ABSTRACT: Infantile hemangioma appears after the birth as a vascular tumor, which is known for its characteristic evolution in 3 phases: rapid augmentation then stabilization and involution on several years with in the best cases, classical “restitutio ad integrum”. Usual surgical attitude is abstention and surgery is proposed only in order to treat sequel. But some particular situations require early surgery for life-threatening lesions or in case of functional impairment. Surgery consists in these cases in a simple volumetric diminution of the tumor with no aim for esthetic improvement. Other kinds of hemangiomas require an early surgical treatment before their complete involution. In some particular locations, deformation or growth delay can occur due to the lesion's development. In some cases, hemangiomas present a delayed involution with minor regression capacity; these are mainly located on the median part of the face and have principally a subcutaneous development. Early surgery can be proposed in order to avoid definitive deformation or growth impairment of adjacent structures. It should be performed before school age and before occurrence of psychological difficulties. Surgery is indicated in a perspective of esthetic improvement. Surgical procedure consists first in modeling excision followed by simple repair technique as linear suture or purse string closure; complex surgical procedures inducing their own sequels are usually inappropriate.
    Annales de Chirurgie Plastique Esthétique 08/2006; 51(4):321-329. DOI:10.1016/j.anplas.2006.07.019 · 0.59 Impact Factor
  • L Mortier · X Mirabel · P Modiano · P Patenotre · F Piette · E Lartigau
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    ABSTRACT: Traditionally melanoma has been considered as a radioresistant tumor. However, recent observations regarding radiobiology and clinical response of melanoma have prompted physicians to re-evaluate the role of radiotherapy in the management of melanoma. Indeed, radiotherapy is frequently used in the treatment of metastatic melanoma but the role of this therapeutic approach in the primary tumor management is unclear. We report 4 cases of thick primary melanoma treated by interstitial brachytherapy. Four patients (3 men, 1 woman; age: 73, 74, 79, 84 years), three with lentigo maligna melanoma and one with nodular melanoma, were treated exclusively by interstitial brachytherapy. The thickness of the 4 tumors was more than 3 mm. This treatment was chosen either because of the impossibility of conservative surgery or because of a contraindication for general anesthesia. Median follow-up was 48 months [18 to 65 months] and we did not observe any local tumor relapse. The cosmetic and functional results of this therapy were excellent. These four cases illustrate the possibility of obtaining good local control of thick primary melanoma by interstitial brachytherapy where surgery is impossible, although without challenging the standard surgical therapy for primary melanoma. Before our study, this treatment was used only in one study to treat melanoma patients. In this case however, interstitial brachytherapy was accompanied by surgery. Therefore, the findings reported here are the first to demonstrate the efficacy of this treatment when used as the sole treatment for primary melanoma. In conclusion, where surgery is difficult or impossible, interstitial brachytherapy may be used to treat primary melanoma with excellent local tumor control and a good cosmetic outcome.
    Annales de Dermatologie et de Vénéréologie 03/2006; 133(2):153-6. · 0.67 Impact Factor
  • L. Mortier · X. Mirabel · P. Modiano · P. Patenotre · F. Piette · E. Lartigau
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    ABSTRACT: Background Traditionally melanoma has been considered as a radioresistant tumor. However, recent observations regarding radiobiology and clinical response of melanoma have prompted physicians to re-evaluate the role of radiotherapy in the management of melanoma. Indeed, radiotherapy is frequently used in the treatment of metastatic melanoma but the role of this therapeutic approach in the primary tumor management is unclear. We report 4 cases of thick primary melanoma treated by interstitial brachytherapy. Case reports Four patients (3 men, 1 woman; age: 73, 74, 79, 84 years), three with lentigo maligna melanoma and one with nodular melanoma, were treated exclusively by interstitial brachytherapy. The thickness of the 4 tumors was more than 3 mm. This treatment was chosen either because of the impossibility of conservative surgery or because of a contraindication for general anesthesia. Median follow-up was 48 months 18 to 65 months. and we did not observe any local tumor relapse. The cosmetic and functional results of this therapy were excellent. Discussion These four cases illustrate the possibility of obtaining good local control of thick primary melanoma by interstitial brachytherapy where surgery is impossible, although without challenging the standard surgical therapy for primary melanoma. Before our study, this treatment was used only in one study to treat melanoma patients. In this case however, interstitial brachytherapy was accompanied by surgery. Therefore, the findings reported here are the first to demonstrate the efficacy of this treatment when used as the sole treatment for primary melanoma. In conclusion, where surgery is difficult or impossible, interstitial brachytherapy may be used to treat primary melanoma with excellent local tumor control and a good cosmetic outcome.
    Annales de Dermatologie et de Vénéréologie 02/2006; 133(2):153-156. DOI:10.1016/S0151-9638(06)70867-5 · 0.67 Impact Factor
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    ABSTRACT: Infantile hemangioma appears after the birth as a vascular tumor, which is known for its characteristic evolution in 3 phases: rapid augmentation then stabilization and involution on several years with in the best cases, classical "restitutio ad integrum". Usual surgical attitude is abstention and surgery is proposed only in order to treat sequel. But some particular situations require early surgery for life-threatening lesions or in case of functional impairment. Surgery consists in these cases in a simple volumetric diminution of the tumor with no aim for esthetic improvement. Other kinds of hemangiomas require an early surgical treatment before their complete involution. In some particular locations, deformation or growth delay can occur due to the lesion's development. In some cases, hemangiomas present a delayed involution with minor regression capacity; these are mainly located on the median part of the face and have principally a subcutaneous development. Early surgery can be proposed in order to avoid definitive deformation or growth impairment of adjacent structures. It should be performed before school age and before occurrence of psychological difficulties. Surgery is indicated in a perspective of esthetic improvement. Surgical procedure consists first in modeling excision followed by simple repair technique as linear suture or purse string closure; complex surgical procedures inducing their own sequels are usually inappropriate.
    Annales de Chirurgie Plastique Esthétique 01/2006; 51(4-5):321-9. · 0.59 Impact Factor
  • C. L. Lavogiez · L. Mortier · F. Laurent · P. Patenotre · F. Piette
    Annales de Dermatologie et de Vénéréologie 10/2005; 132:155-156. DOI:10.1016/S0151-9638(05)79868-9 · 0.67 Impact Factor
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    ABSTRACT: The lateral brachial flap is a fascio-cutaneus flap. This flap is secured. The functional and cosmetic sequelae are limited. The authors propose in this paper its utilisation as free flap in the reconstruction of facial defects. Thanks to its low morbidity, this free flap may be used in old patients.
    Annales de Chirurgie Plastique Esthétique 09/2005; 50(4):275-81. · 0.59 Impact Factor
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    ABSTRACT: The lateral brachial flap is a fascio-cutaneus flap. This flap is secured. The functional and cosmetic sequelae are limited. The authors propose in this paper its utilisation as free flap in the reconstruction of facial defects. Thanks to its low morbidity, this free flap may be used in old patients.
    Annales de Chirurgie Plastique Esthétique 08/2005; 50(4):275-281. DOI:10.1016/j.anplas.2005.04.003 · 0.59 Impact Factor
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    ABSTRACT: The dermatofibrosarcoma protuberans (DFSP) is a rare but not exceptional tumour. Surgical treatment should contain a wide excision to avoid local recurrence. We report a retrospective study of 34 cases treated by the same team from 1994 to 1999. In this series, only 4 cases (12%) presented recurrences after previous treatment by the other teams. In all cases, surgical resection was performed with 3 cm lateral margin and a disease free anatomic layer removed with the tumour. The mean of follow up was 60 months. There was no recurrence case in our 34 patients during this period. We compare our results with those, from others teams described in international literature since 1951. Margins and results are similar with some teams who practice the Mohs surgery. These data are in favour of a reduction of the lateral margins in classical surgical procedure of DFSP. They should be consolidated by a follow-up in longer term with a prospective study.
    Annales de Chirurgie Plastique Esthétique 07/2005; 50(3):179-85; discussion 186-8. · 0.59 Impact Factor
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    ABSTRACT: Introduction. – The dermatofibrosarcoma protuberans (DFSP) is a rare but not exceptional tumour. Surgical treatment should contain a wide excision to avoid local recurrence.Materiel and method. – We report a retrospective study of 34 cases treated by the same team from 1994 to 1999. In this series, only 4 cases (12%) presented recurrences after previous treatment by the other teams. In all cases, surgical resection was performed with 3 cm lateral margin and a disease free anatomic layer removed with the tumour.Results. – The mean of follow up was 60 months. There was no recurrence case in our 34 patients during this period. We compare our results with those, from others teams described in international literature since 1951. Margins and results are similar with some teams who practice the Mohs surgery.Conclusion. – These data are in favour of a reduction of the lateral margins in classical surgical procedure of DFSP. They should be consolidated by a follow-up in longer term with a prospective study.
    Annales de Chirurgie Plastique Esthétique 06/2005; 50(3):179-185. DOI:10.1016/j.anplas.2005.03.006 · 0.59 Impact Factor
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    ABSTRACT: The sebaceous hamartoma of Jadassohn is a congenital skin malformation usually appeared at birth or in early childhood. Many authors support the notion that early complete surgical excision is necessary to prevent the development of malignant neoplasms (especially basal cell carcinoma) after puberty. On the contrary, others in recent large series suggest that it is an histological misdiagnosis: the basal cell-carcinoma is in fact a trichoblastoma, basaloïd neoplasm, but non-malignant one. We have also asked anatomopathologist for proofreading slide previously described as basal cell carcinoma to research unknown trichoblastoma. During the period, 1982 to 1999, 80 sebaceous hamartoma of Jadassohn were excised and 19 basal cell carcinoma were found. The basal cell carcinoma diagnosis has been confirmed in two cases only. The others were pigmented trichoblastomas. So, trichoblastoma is the most common basaloïd tumor developed in sebaceous of hamartoma Jadassohn. Nevertheless, we should recommend surgical excision during the childhood because of best elasticity of tissue, especially on the scalp where it's mostly localized.
    Annales de Chirurgie Plastique Esthétique 07/2002; 47(3):210-3. · 0.59 Impact Factor
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    ABSTRACT: To elucidate hospital mortality, morbidity and actuarial survival rates of patients with carcinoma of the hypopharynx and cervical oesophagus and to identify the technique of choice for reconstruction after pharyngolaryngectomy. We reviewed the records of 209 patients who underwent total pharyngolaryngectomy between May 1982 and January 2000. The majority of patients had advanced cancer: hypopharyngeal in 131 cases and cervical oesophageal in 78 cases. Follow-up was complete for all patients. Chi 2 and log rank tests were used, with a limit of significance of 5%. The postoperative mortality and morbidity rates were 4.8% and 38.3%, respectively. Alimentary continuity was achieved using the stomach (127 patients), colon (5 patients), or free jejunal autograft (77 patients). The 1-year and 5-year survival rates were 62% and 24%, respectively. There was no significant difference with regard to the survival between gastric transposition and free jejunal autograft, but there were fewer complications in the gastric pull-up group with regard to the respiratory complications (33% vs 47.0%, p < 0.05), local recurrences (15.8% vs 33.8%, p = 0.004) and survival without dysphagia (76% vs 89%, p < 10(-5)). Surgical ablation is a viable option for advanced hypopharyngeal and cervical oesophageal neoplasms, and stomach interposition is the preferred method of reconstruction.
    Annales de Chirurgie 07/2002; 127(6):431-8. · 0.52 Impact Factor
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    ABSTRACT: Aim of the study: To elucidate hospital mortality, morbidity and actuarial survival rates of patients with carcinoma of the hypopharynx and cervical œsophagus and to identify the technique of choice for reconstruction after pharyngolaryngectomy.Patients and methods: We reviewed the records of 209 patients who underwent total pharyngolaryngectomy between May 1982 and January 2000. The majority of patients had advanced cancer: hypopharyngeal in 131 cases and cervical œsophageal in 78 cases. Follow-up was complete for all patients. Chi 2 and log rank tests were used, with a limit of significance of 5%.Results: The postoperative mortality and morbidity rates were 4.8% and 38.3%, respectively. Alimentary continuity was achieved using the stomach (127 patients), colon (5 patients), or free jejunal autograft (77 patients). The 1-year and 5-year survival rates were 62% and 24%, respectively. There was no significant difference with regard to the survival between gastric transposition and free jejunal autograft, but there were fewer complications in the gastric pull-up group with regard to the respiratory complications (33% vs 47.0%, p < 0.05), local recurrences (15.8% vs 33.8%, p = 0.004) and survival without dysphagia (76% vs 89%, p < 10–5).Conclusion: Surgical ablation is a viable option for advanced hypopharyngeal and cervical œsophageal neoplasms, and stomach interposition is the preferred method of reconstruction.
    Annales de Chirurgie 06/2002; DOI:10.1016/S0003-3944(02)00793-9 · 0.52 Impact Factor